Correlation Analysis of " Toxin Damaging Brain Collaterals" from Glymphatic System / 中国实验方剂学杂志

The collaterals are branches of the meridians and vessels system, and have the roles of connecting upper-lower and interior-exterior portions of the body, the characteristics of two-way flow in supporting the operation of Qi and blood, and the functions of material exchange and metabolism. The brain is the intersection of the Yang meridians. Crisscross brain collaterals permeate Qi and blood to enrich the brain, and spread Yang Qi, in order to warm the brain-mind, and provide material basis and source power to the " brain governing mind" . Under pathological conditions, cerebral collaterals are blocked, and toxic pathogens are endogenous, resulting in " toxin damaging brain collaterals" . This theory is not only applied to the study of stroke pathogenesis, but also extended to other encephalopathy, such as dementia, which promoted the development of the theory of pathogenesis in traditional Chinese medicine. Recently, a " glymphatic system" was discovered in the brain, which is an exchange flow system of cerebrospinal fluid-brain interstitial fluid mediated by astrocyte. The glymphatic system transports nutrients and neuroactive substances, such as glucose, lipids, electrolytes and apolipoprotein E in the cerebrospinal fluid, to brain tissue, and also removes metabolic products (such as lactic acid), soluble proteins (such as β-amyloid protein and Tau protein) from the brain and foreign bodies, which are important liquid flow systems that maintain the homeostasis of the brain. The discovery of the glymphatic system provides a new perspective for the study of pathological mechanism of neurological diseases, and may become a new target for interventions in neurological diseases, such as cerebrovascular diseases and neurodegenerative diseases. As a widely distributed cerebral metabolic waste removal way and material delivery system, the lymphatic system may be the biological foundation of " brain collateral" disease, and a cross point of understanding on " toxin impairing brain collaterals" by Western and traditional Chinese medicine. The study based on the glymphatic system will give a more rational explanation on " toxic damage to brain collaterals" .

Clinical observation of axial offset after treatment by Ilizarov bone transport technology / 中国骨伤

<p><b>OBJECTIVE</b>To observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology.</p><p><b>METHODS</b>From January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment.</p><p><b>RESULTS</b>All patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases.</p><p><b>CONCLUSION</b>Axial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.</p>

Inhibition of Nogo expression to promote repair after spinal cord injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>One of the reasons for poor neuroregeneration after central nervous system injury is the presence of inhibitory factors such as Nogo. Here, we tested the inhibition of Nogo by RNA interference both in vitro and in vivo, using recombinant adenovirus-mediated transfection of short hairpin RNAs, to explore a new method of treatment for spinal cord injury.</p><p><b>METHODS</b>We designed and cloned two Nogo-specific short hairpin RNAs and an unrelated short hairpin RNA, packaged the clones into adenovirus, and amplified the recombinant virus in 293 cells. We then tested the inhibition of Nogo expression both in vitro in adenovirus-transfected oligodendrocytes and in vivo in spinal cord tissue from adenovirus-transfected spinal cord injury model rats. We tested Nogo expression at the mRNA level by reverse-transcription PCR and at the protein level by Western blotting and immunohistochemistry.</p><p><b>RESULTS</b>In vitro, the two specific Nogo short hairpin RNAs decreased Nogo mRNA expression by 51% and 49%, respectively, compared with Nogo expression in cells transfected with the unrelated control small hairpin RNA (P < 0.005). Similarly, Nogo protein expression decreased by 50% and 48%, respectively (P < 0.005). In vivo, in spinal cord injury model rats, the two specific Nogo short hairpin RNAs decreased Nogo mRNA expression by 45% and 40%, respectively, compared with Nogo expression in spinal cord injury model rats transfected with the unrelated control short hairpin RNA (P < 0.005). The Nogo protein level was similarly decreased.</p><p><b>CONCLUSIONS</b>We were successful in specifically downregulating Nogo at the mRNA and protein levels by adenovirus-mediated delivery of short hairpin RNAs, both in vitro and in vivo. This confirms the effectiveness of RNA interference for the inhibition of Nogo gene expression and the efficiency of using adenovirus for delivery. Thus gene therapy may be an effective treatment for spinal cord injury.</p>

Application of external skin expansion in repair of massive skin and soft tissue defects / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect of external tissue expansion in the repair of massive skin and soft tissue defects.</p><p><b>METHODS</b>From August 1998 to January 2004, 10 patients with massive skin and soft tissue defects ( the area ranging from 10 cm x 4 cm to 24 cm x 15 cm) , including 7 with wounds in the leg, 2 with wounds in knee region, and 1 with wounds in the forearm, were enrolled in the study. All patients were subjected to external tissue expansion together with external skeletal fixation for 2 -3 weeks, then the wounds were closed with suturing or supplemented with skin flaps.</p><p><b>RESULTS</b>The defects were closed completely after external expansion in 4 cases, and in other 5 cases the wounds were significantly decreased in area, and the residual wounds were covered with free skin grafting. In I case the wound could only be reduced in size, and the residual wound was closed with a local flap. Follow-up from 1 to 12 months showed that the wounds were closed with normal cutaneous sensation and good appearance.</p><p><b>CONCLUSION</b>External skin expansion is a simple, economical method for repair of massive skin soft-tissue defect, which can significantly be reduced or entirely closed.</p>

Impact factors of prognosis of spinal cord injury patients / 中国康复理论与实践

@#ObjectiveTo explore the influence factors of prognosis of spinal cord injury patients. MethodsFollow-up data of 121 cases with spinal cord injury was analysed with retrospective cohort study.ResultsThe highest recover rate was in the patients who accepted the special rehabilitation therapy,while that of recovering two class was in the patients who accepted the magnetic stimulation.Conclusions Special recovering cure and magnetic stimulation can surely promote recovery of spinal cord injury patients.